Prevalence of hypovitaminosis D and factors associated in a sample of HIV patients
Presented by Daria Pocaterra (Italy).
D. Pocaterra1, E. Ricci1, L. Carenzi1, M. Schiavini1, P. Meraviglia1, D. Minisci1, M. Campaniello1, C. Gervasoni1, M. Bevilacqua2, G. Rizzardini1, P. Bonfanti1
1L.Sacco Hospital, Infectious Diseases, Milan, Italy, 2L.Sacco Hospital, Endocrinologic Unit, Milan, Italy
Background: bone metabolism alteration is an important issue in HIV patients even if pathogenesis of mineral density loss is not yet disclosured. Vitamin D has a central role in the regulation of bone mineralisation favoring the bowel absorption of calcium and phosphorus and decreasing the calcium kidney excretion. A deficit of 25-OH vitamin D stimulates the release of parathormone (PTH) which activate osteoclastic bone resorption in order to rebalance calcium serum levels.
Objectives: the aim of this study is to evaluate the prevalence of hypovitaminosis D and to investigate its relationship with serum PTH levels in a sample of HIV-positive patients on HAART.
Methods: we performed a cross-sectional analysis considering immunovirological parameters, serum levels of 25-OH vitamin D, PTH and phosphorus, and HAART treatment in our outpatient clinic for the management of HAART-related toxicity. Univariate and multivariate linear regression analyses were conducted to identify the significance of the relationships among the variables.
Results: 281 patients were included. The mean age was 47 (range 32-75). Males were 57.6%.Hypovitaminosis (< 30 ng/dl) was detected in 225 (80.1%) patients; among these, 95 (33.8%) had severe hypovitaminosis D(< 15 ng/ml). Among 164 patients (58.4%) on TDF-based treatments, hypovitaminosis was detected in 127 (77.4%).Univariate analyses showed that serum PTH was significantly associated with gender, 25-OH vitamin D and TDF use. In a multiple linear regression analysis, these variables were confirmed as independently related to serum PTH levels.
Conclusions: the main result of this study is the remarkably high prevalence of hypovitaminosis D in our cohort. Furthermore, investigating the inverse correlation existing between 25-OH vitamin D and PTH, we found that patients on TDF-based treatment had higher levels of PTH than patients not on TDF but similar vitamin D levels.
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